The bacterium is Yersinia pestis, and it still exists. Rodents are the reservoir for the disease. Their fleas are the vector that carries the bacterium from host to host. Humans usually catch it from a flea bite. Left alone, the bubonic form settles in the lymph nodes and produces the swellings called buboes. It can move into the blood and into the lungs. Once in the lungs, pneumonic plague passes on the breath.
The Black Death
The pandemic that would be called the Black Death began in Central Asia, reached the Black Sea and the Mediterranean around 1346–1347, and ran through Europe and the Mediterranean world, including Northern Africa, until about 1353. people at that time did not use the name. They said the pestilence, or the great mortality. “Black Death” is a later label for that specific wave.
The death toll is argued in the details and not in the scale. A third to three-fifths of Europe is the usual range. Tens of millions of people. Cities hired doctors at emergency rates because the ordinary ones fled or died. The city of Orvieto, in central Italy, contracted Matteo fu Angelo in 1348 at four times a normal fee. Pope Clement VI added doctors in Avignon. In Venice, of eighteen doctors in the city, one was still at work by the end: five dead, twelve fled. Those men were plague doctors in the job sense. They did not wear the costume and the beak at that time.
A 1373 note by Johannes Jacobi recommends masks for physicians. It does not describe them. No surviving evidence puts the bird mask in the fourteenth century. The plague doctor costume people think of is three hundred years later.
The Plague Never Fully Went Away
The bacterium did not leave with the end of Black Death. Europe had plague outbreaks for centuries after 1353. Most were local. Some were bad enough to empty quarters of a city. The name “Great Plague” is not a second Black Death. In English it usually refers to the London epidemic of 1665–1666, with about 100,000 dead in the city, roughly a quarter of its population. Other places had their own great plagues: Naples and Rome in 1656, Vienna in 1679, and Marseille in 1720. Same organism, but less wide-spread. By then towns had boards of health, quarantine, and pesthouses. They also had the outfit.
The Beak of the Plague Doctor
Charles de Lorme, physician to Louis XIII, described the kit during a Paris outbreak in 1619. Waxed Moroccan goat leather: long coat, breeches joined to boots, gloves, hat. A mask with glass over the eyes and a beak about half a foot long, packed with herbs, vinegar, perfume, or theriac, a compound of dozens of ingredients that included viper flesh, myrrh, cinnamon, and honey. The idea was miasma, the bad air carried the pestilence. A long beak was supposed to give the herbs time to clean the breath before it reached the lungs. He also carried a rod, to point, to lift a sheet, or to keep a patient off him.
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| Paul Fürst, Der Doctor Schnabel von Rom |
The costume was never standard issue. Most physicians who treated plague did not wear it. Some did. Two masks survive, both from seventeenth century Germany. The look lasted as a warning longer than it lasted as equipment. It appears again in images of the 1720 Marseille outbreak. After that it belongs to prints, theater, and masks.
The theory under it was wrong. The beak did not stop the fleas. A waxed coat may have kept some fleas off a man’s skin. That would have been an accident of the leather, not a success of the herbs. Pneumonic cases would have made it through the herbs and perfume unchanged.
The role is older than the costume. Cities were already paying men to walk into plague houses in 1348. The beak is a seventeenth-century object, tied to de Lorme’s 1619 description, the 1656 image from Italy, and the surviving masks from Germany.
The plague did not retire with the last European city outbreak. It still moves in rodent populations in parts of Asia, Africa, and the Americas, including the United States. Cases still occur. Antibiotics stop it if they are given before the blood or the lungs are gone.
- John Kelly, The Great Mortality: An Intimate History of the Black Death. Narrative history of the fourteenth-century pandemic for a general reader.
- Ole J. Benedictow, The Black Death, 1346–1353: The Complete History. The demographic case for the high death toll.
- Paul Slack, Plague: A Very Short Introduction. Short, sober map of the disease from Justinian’s plague through the later European outbreaks.
- William Rosen, Justinian’s Flea: Plague, Empire, and the Birth of Europe. The earlier pandemic, sixth century, same bacterium, different world.
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